Individual
SCOTT B WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
431 MEADOWLARK ST, SHAW AFB, SC 29152-5019
(321) 961-1447
Mailing address
431 MEADOWLARK ST, SHAW AFB, SC 29152-5019
(321) 961-1447
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
09/07/2012
Last updated
06/12/2013
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